The Dark Side of Compassion: When Caring Becomes a Career Killer

In one harrowing Reddit post, a veterinary nurse recounts a medication error that almost harmed a patient. “I was so embarrassed and ashamed of myself… I don’t know, this haunts me. The way I was careless. The way the doctor scolded me. The way the other nurses look down on me. The error of affecting MY patient negatively. It kills me”[1]. This heartfelt confession is not an isolated incident. It’s one of 1,888 online posts by veterinary professionals that reveal a concerning pattern of self-inflicted cognitive burdens. In an analysis of these posts, three recurring mental habits emerged—perfectionism, rumination, and perseverative cognition—forming what can be described as a “New Dark Triad” of the veterinary mind. Unlike the classic psychological Dark Triad (narcissism, Machiavellianism, and psychopathy) that harms others, this triad insidiously harms the self. It represents a blend of relentless self-critique, chronic overthinking, and inability to mentally disconnect that is pervasive in veterinary medicine today.

What did the data show? Nearly every post analyzed fell into one or more of these three themes. Perseverative cognition—continuous worry or obsessive thinking about work—was the most common, present in about 44% of the posts. Perfectionism-related narratives accounted for roughly 38%. The remainder (~17%) centered on rumination, that is, mentally replaying mistakes or negative events. In practical terms, hundreds of vets, nurses, and students wrote about feeling “never good enough,” being haunted by errors, or unable to “turn off” work thoughts after hours. These patterns, as we will see, have serious implications for emotional health and even the quality of care delivered.

The Self-Destructive Triad of Perfectionism, Rumination, and Overthinking

Veterinary work is often described as a calling fueled by compassion and high standards. But these same virtues can morph into vicious internal stressors. A recent industry article noted that beyond external pressures like long hours, internal factors (like perfectionism and rumination) are major drivers of chronic stress[2]. Our analysis suggests that perfectionism, rumination, and perseverative cognition form a triad of self-destructive thinking that is alarmingly common among veterinary professionals.

• Perfectionism: “Never Good Enough.” Many veterinary staff hold themselves to near-impossible standards. They agonize over any outcome short of perfect. In the dataset, phrases like “never good enough,” “afraid to mess up,” and “terrified of mistakes” appeared in hundreds of posts, reflecting a culture of excessive self-criticism and fear of error. One emergency veterinarian described the crushing weight of this mindset: “I dread going to work. I’m constantly afraid of messing up [and that] I’ll get sued or lose my license. I feel like I’m not a good veterinarian a lot of the time… sometimes I make stupid avoidable mistakes”[3]. Such perfectionism is not merely a personality quirk – it’s a known risk factor for burnout. Studies have shown that high perfectionistic strivings, especially without self-compassion, predispose individuals to burnout[4]. In other words, always expecting oneself to never falter is a recipe for chronic stress and emotional exhaustion.

• Rumination: Replaying Regrets. Even when not actively on the job, many professionals cannot escape persistent replaying of adverse events. Classic rumination language pervades the posts: “can’t stop thinking about it,” “it still haunts me,” “keep replaying every detail.” These veterinarians and technicians relive mistakes or bad outcomes repeatedly in their minds. The quote that opened this article is one such example – a nurse fixating on a single overdose error despite the patient recovering fine. “Should I be this hard on myself?” she asks rhetorically[5], highlighting how guilt and self-blame linger long after an incident. Rumination is essentially a mental trap: the mind cycles through the what-ifs and if-onlys, with little resolution. This pattern not only fuels anxiety and sadness, but also extends the physiological stress response. Psychologists include rumination as a form of perseverative cognition – the mind’s repeated activation of a stressor even when the real event is over[6]. In short, the body continues to feel as if the failure is happening anew each time it’s remembered. Little wonder that ruminators often report trouble sleeping, concentration lapses, and a sense of being drained by their own thoughts.

• Perseverative Cognition: Impossible to “Turn Off.” The third theme, perseverative cognition, refers to the inability to mentally detach from work-related thoughts, worries, or duties. This goes beyond reflecting on a specific mistake – it’s an ongoing state of hyper-vigilant thinking about work problems, even during supposed downtime. A striking number of posts described this compulsive mental state. “I am so incredibly anxious all the time, and I think about work before I go, and after I leave. I’ve even been having graphic nightmares that have been keeping me up,” wrote a new graduate in her first months at an ER clinic[7]. Another person confessed, “I’m always on edge and frustrated at work… I show up, do my job then go home, but it’s like I can’t shut my brain off afterwards.” In our dataset, over 300 posts mentioned thoughts like “constantly thinking about work” or inability to relax outside of work. This constant cognitive arousal is more than just an annoyance – it has documented physiological effects. Research on the perseverative cognition hypothesis has shown that continuous mental stress elevates heart rate, blood pressure, and cortisol levels in both daily life and lab settings[8]. Essentially, if your mind never truly clocks out, neither does your body. Over time, this contributes to allostatic load, the cumulative “wear and tear” on the body from chronic stress exposure[9].

Together, these three patterns form a potent triad. We might call it “overcare” – an overdose of caring and concern that paradoxically harms the caregiver. A perfectionistic veterinarian cares so much about getting everything right that they cannot forgive themselves for being human. A ruminating technician cares so much about a patient’s outcome that one adverse event torments them for weeks. An overthinking vet student cares so much about their future that they sacrifice any mental respite, turning their passion into a chronic source of anxiety. This New Dark Triad doesn’t involve malice or ego; it’s born from dedication and empathy, gone awry.

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